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med209 > structure and function of the hand > Flashcards

structure and function of the hand Flashcards

1
Q

what is the flexor retinaculum?

A

thickening of the deep fascia, it stretches across palmar surfaces of carpal bones

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2
Q

how is the flexor retinaculum attached?

A

medially to pisiform &hook of hamate.

Laterally to scaphoid & trapezium.

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3
Q

what is the palmar aponeurosis

A

triangular in shape and occupies central part of the palm

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4
Q

how does the palmar aponeurosis attach

A

tip attaches to distal border of flexor retinaculum
– It receives insertion of tendon of the palmaris longus
– Its base is divides into 4 slips which fuse with fibrous flexor sheath and deep transverse ligaments

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5
Q

what is the function of the palmar aponeurosis

A

Improves grip strength.
It protects the underlying
structures in the palm.

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6
Q

what is the name of the deformity resulting in fibrosis of the palmar aponeurosis

A

Dupuytren’s contracture

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7
Q

what is the effects of the dupuytrens contracture

A

Thick, scar-like tissue forms under the skin of the palm and may extend
into the fingers, pulling them toward the palm and restricting motion.

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8
Q

what are some treatments of dupuytrens contracture

A
  1. Stretch.
  2. Steroids & enzymes injection.
  3. Radiations.
  4. Needle aponeurotomy.
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9
Q

what does the carpal tunnel transmit

A
  1. Median nerve.
  2. Flexor digitorum superficialis & profundus tendons with the
    synovial sheath (ulnar bursa).
  3. Flexor pollicis longus tendon with its synovial sheath (radial
    bursa)
  4. Flexor carpi radialis tendon with its synovial sheath.
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10
Q

the muscles of the thumb are made up of thenar muscle group and adductor pollicis. what is this group made up of

A
  1. Abductor pollicis brevis
  2. Flexorpollicisbrevis
  3. Opponens pollicis
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11
Q

thenar muscle have a common origin what is it?

A

Common Origin:

Flexorretinaculum & trapezium.

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12
Q

what is the origin and insertion points of adductor pollicis

A

Origin: Palmar surface of 2nd & 3rd metacarpals.
Insertion:Medial side of base of proximal phalanx of thumb.

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13
Q

what are the origin and insertion points of palmar brevis

A

Origin:Palmar aponeurosis
Insertion:Skin on the medial margin of the hand.

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14
Q

what is the origin points of

  1. Abductor digiti minimi
  2. Flexordigitiminimi
  3. Opponensdigitiminimi
A

they share a common origin:Flexor retinaculum & hamate

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15
Q

what are the insertion points of

  1. Abductor digiti minimi
  2. Flexordigitiminimi
  3. Opponensdigitiminimi
A
  1. Abductor digiti minimi:Base of proximal phalange of little finger medially.
  2. Flexor digiti minimi: Base of proximal phalange of little finger
  3. Opponens digiti minimi:Medial margin of metacarpal
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16
Q

what is the origin of the lumbrical muscles(4 small, cylindrical muscles for the medial 4 fingers)

A

1st & 2nd from lateral sides of tendons of flex. dig. Prof.
3rd & 4th from adjacent sides of tendons of flex. dig. Prof.

17
Q

what is the insertion of the lumbrical muscles

A

common insertion point:extensor expansions

18
Q

what is the action of the lumbrical muscles

A

They flex the metacarpo- phalangeal joints and extend the inter- phalangeal joints (the writing position).

19
Q

where is the origin of palmar interossei muscles

A

1st & 2nd from the medial side of first & second metacarpals
respectively.
4th & 5th from the lateral side of the fourth & fifth
metacarpals respectively.

20
Q

where is the insertion of palmar interossei muscles

A

extensor expansions

21
Q

what are the actions of palmar interossei muscles

A
  1. Like the lumbricals.
  2. Adduct the thumb, index & the little ,ring
    fingers towards the central axis which pass through the middle finger around which the other fingers move.
22
Q

what is the origin of the dorsal interossei muscles

A
  1. Like the lumbricals.

2. Abduct the index, middle & the little, ring fingers from the central axis which pass through the middle finger.

23
Q

what nerve supplies to the palmar and dorsal aspects of medial 1/3 of hand & medial 1 ½ digits.

A

the ulnar nerve

24
Q

what part of the hand does the median nerve suply

A

Sensory to skin of the lateral 2/3 of the palmar aspect of hand & lateral 3 ½ digits (including dorsal aspect of their distal phalanges).
Motor to thenar muscles &lateral 2 lumbrical muscles.

25
Q

what part of the hand does the radial nerve supply

A

It supplies the skin of lateral 2/3 of the dorsal surface of the hand & the skin of the dorsal surface of the lateral 3½ fingers except the distal phalanges which are supplied by median nerve.

26
Q

which 2 arteries form the deep palmar arch in the hand

A

It is formed by the radial artery and the deep palmar branch of the ulnar artery.

27
Q

where is the deep palmar arch located

A

It is located between the long flexor tendons and the metacarpal bones.

28
Q

which 2 arteries form the superficial palmar arch

A

It is formed by the ulnar artery and the superficial branch of radial artery. .

29
Q

where is the superficial palmar arch located

A

It is located between the palmar aponeurosis and long flexor tendons.

30
Q

how is the dorsal venous network of the hand drained

A

Dorsal venous network drains proximally into cephalic vein laterally and basilic vein medially.

31
Q

what causes carpal tunnel syndrome

A

increase size of some of the structures passing through the tunnel e.g. excessive exercise of the fingers , trauma&raquo_space; swelling/infection&raquo_space; compression of the median nerve.

32
Q

what would be the your diagnosis if a patient came in with Weakness in thenar muscles (recurrent branch).
Numbness and tingling in the lateral 3 ½ fingers.
The palmar aspect of the lateral 2/3 of hand is spared because palmer cutaneous nerve is spared because it passes superficial to the retinaculum.

A

these symptoms of carpal tunnel syndrome

33
Q

how do we treat carpal tunnel syndrome

A

Immobilization and ice

Surgery to increase space in the tunnel.

med209 (19 decks)

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